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February 14, 2006

Delayed prostate cancer surgery probably okay

by Sam Savage

NEW YORK (Reuters Health) - The time elapsed between a
diagnosis of localized prostate cancer and surgery does not
appear to have a large effect on the risk of cancer recurrence,
according to a study. However, doctors say it's best to avoid
undue delays.

Men diagnosed with localized prostate cancer must educate
themselves about the disease and the available treatment
options. This can take time, often leading to delays in
treatment. Waiting lists for surgery may also delay treatment.

Whether a delay in therapy for localized prostate cancer
has an adverse impact on outcome is the subject of debate, Dr.
Andrew J. Vickers and colleagues from Memorial Sloan-Kettering
Cancer Center in New York City note in the journal Cancer.

Using data from 3149 patients who had undergone prostate
surgery, they developed a mathematical model to evaluate
whether the time from biopsy to removal of the diseased
prostate can predict recurrence of the disease.

"We found no clear evidence that an increased time between
biopsy and surgery was associated with a significantly poorer
outcome," the authors report. "This suggests that any effect of
a treatment delay is moderate, at least for a time period up to
6 to 12 months."

The reason for the findings may lie in the fact that
prostate cancer is a relatively slow growing tumor.

"We were unable to prove that there was an effect of a
delay in diagnosis on recurrence, but the lack of proof of an
effect doesn't mean that there is no effect," Vickers
emphasized in comments to Reuters Health.

In the absence of clear data, doctors "need to have some
clinical judgment," Vickers said. "If someone has an aggressive
cancer, waiting around is not a sensible thing to do, but if
the cancer is not aggressive, then you might take some time to
make a decision," he concluded.